Calling it the largest initiative against healthcare fraud and abuse in history, Clinton administration officials last week announced a five-state program concentrating on home health agen-cies, nursing homes and durable medical equipment.
The administration said it also intends to push for legislation that would allow federal officials to extend the current Medicare and Medicaid civil monetary and criminal penalties to all healthcare providers. The bill would allow HHS' inspector general's office to recycle some of the funds recovered in fraud cases to fund new investigations, according to Inspector General June Gibbs Brown.
The proposals are expected to be part of the second phase of the administration's "reinventing government" proposal, which is due to be unveiled soon.
The two-year fraud-and-abuse project announced last week will focus on five states: California, Florida, Illinois, NewHealthcare fraud
York and Texas. Those states account for nearly 40% of all Medicare and Medicaid beneficiaries, according to HCFA. The program will be extended to other states as funding permits, Brown added.
A report released last year by the Senate Aging Committee estimated that there is as much as $100 billion a year in healthcare fraud.
Under the new program, companies that have uncovered internal evidence of Medicare or Medicaid fraud would be able to turn that evidence over to federal authorities in exchange for a reduced penalty, Brown said.
The voluntary disclosure program extends to any healthcare provider, a spokesman for the inspector general's office said.
As many as 14 different agencies will participate in the new initiative, which will shorten by a third the time it takes to bring healthcare fraud cases to court, according to Jim Kopf, HHS' chief inspector. The average case now takes 18 to 30 months to move from an investigation to an indictment, Kopf added.
Within the next six months, the inspector general's office intends to issue as many as eight "fraud alerts" designed to give firms guidance on what areas investigators will be concentrating their efforts and what they can do to avoid legal problems.